disability, feminism and campagining

Updated PIP Assessment Guide

The government have provided another update to the PIP Assessment Guide. It’s still not the final version, but it’s the best we have to work with so far.

Before I go any further, this guide isn’t legislation. It’s not the law but it is the guidance ATOS/Captia (depending on where you live), the DWP and Tribunal Judges should be working from when making decisions.

The two area’s of particular concern many of us campaigners raised in response to Decembers release of PIP criteria were; the loss of reliably, repeatedly safely and in a timely manner from the legislation and the reduction of the distance people need to be able to physically mobilise to automatically get the enhanced level of PIP from 50m to a puny 20m. Naturally I would like to see the former put into legislation for added protection and the latter decision reversed. As that hasn’t happened (yet) I think it’s important to look at how the guidelines will/won’t protect us if we are unfortunate and do not manage to get those changes made.

These two areas are covered in section 3.3.Reliability.

The document says;

“3.2.7. For a descriptor to be able to apply to a claimant, the claimant must be able to reliably complete the activity as described in the descriptor. More information on this can be found in section 3.3.”

Then goes on to say;

“3.3.1.Central to the application of all the activities within the PIP assessment is a consideration of the manner in which they are undertaken. If an individual cannot reliably complete an activity in the way described then they should be considered unable to complete it.3.3.2. Considering reliability involves looking at whether the claimant can complete the activity as described:• Safely – being able to complete the activity in a fashion that is unlikely to cause harm to themselves or to another person.• To an acceptable standard, given the nature of the activity.• Repeatedly – being able to repeat the activity as often as is reasonably required.• In a timely manner – being able to complete the activity in a reasonable time period.”

Which is fairly reassuring, it means that the assessors shouldn’t apply a descriptor unless it meets the reliably, repeatedly, safely & in a timely manner conditions. You can read up on example of those in the guide (Section 3.3, page 72). Of course those with fluctuating conditions have been pretty confused about how these four descriptors should be them. That is covered by the guidance too, it says;

“3.2.9. A scoring descriptor can apply to claimants in an activity where their impairment(s) affects their ability to complete an activity, at some stage of the day, on more than 50 per cent of days in the 12 month period. The following rules apply:• If one descriptor in an activity is likely to apply on more than 50 per cent of the days in the 12 month period – i.e. the activity can be completed in the way described on more than 50 per cent of days – then that descriptor should be chosen.• If two or more descriptors in an activity is likely to apply on more than 50 per cent of the days in the period, then the descriptor chosen should be the one which is the highest scoring.• Where one single descriptor in an activity is likely to not be satisfied on more than 50 per cent of days, but a number of different scoring descriptors in that activity cumulatively are likely to be satisfied on more than 50 per cent of days, the descriptor likely to be satisfied for the highest proportion of the time should be selected. For example, if descriptor ‘B’ is likely to be satisfied on 40 per cent of days and descriptor ‘C’ on 30 per cent of days, descriptor ‘B’ should be chosen. Where two or more descriptors are satisfied for the same proportion of days, the descriptor which is the highest scoring should be chosen. ”

Taking this as it stands it means that theoretically the DWP, Atos & Captia should have a hard time excluding people who should be covered by this umbrella. Of course they’d have a harder time if those words were in the actual legislation.

It’s not a win, but I feel it’s quite positive. The guidance isn’t overly vague which will make it harder for them to find loop holes. I do think it’s quite harsh in some areas, take this example;

“Mr X is able to stand and move unaided. He can comfortably walk up to 150 metres at a normal pace. After 150 metres he starts to become breathless and to experience some mild pain. He can continue to walk but his pace slows. The pain and breathlessness gradually increases and after 250 metres he needs to stop and rest for about 5 minutes before starting to walk again. Mr X can repeatedly walk 250 metres, with short 5-minute rests in between for around an hour. After an hour of this, he needs a longer rest of about an hour before walking again. It takes Mr X around four minutes to walk 200 metres.”

It then explains that Mr X would be judged as being able to mobilise safley, reliably, repeatedly and in a timely manner. I think that underestimates how short that kind of distance is and how hard it can be to find somewhere to rest. It also doesn’t look at the psychological implications of having to walk until you are in agony then stop, rest and do it all again. Though I suppose that would be covered by activity 11, planning & following journeys.

“The second area of concern is activity 12, moving around. The guidance has the following notes added to it;

This activity should be judged in relation to a type of surface normally expected out of doors such as pavements on the flat and includes the consideration of kerbs.

20 metres is considered to be the distance that a claimant is required to be able to repeatedly walk in order to achieve a basic level of independence in the home.50 metres is considered to be the distance that a claimant is required to be able to repeatedly walk in order to achieve a basic level of independence outdoors.50 to 200 metres is considered to be the distance that a claimant is required to be able to repeatedly walk in order to achieve a higher level of independence outdoors.

Standing means to stand upright with at least one biological foot on the ground with or without suitable aids and appliances (note – a prosthesis is considered an appliance so a claimant with a unilateral prosthetic leg may be able to stand whereas a bilateral lower limb amputee would be unable to stand under this definition).

“Stand and then move” requires an individual to stand and then move independently while remaining standing. It does not include a claimant who stands and then transfers into a wheelchair or similar device. Individuals who require a wheelchair or similar device to move a distance should not be considered able to stand and move that distance.

Aids or appliances that a person uses to support their physical mobility may include walking sticks, crutches and prostheses.

When assessing whether the activity can be carried out reliably, consideration should be given to the manner in which they do so. This includes but is not limited to, their gait, their speed, the risk of falls and symptoms or side effects that could affect their ability to complete the activity, such as pain, breathlessness and fatigue.

However, for this activity this only refers to the physical act of moving. For example, danger awareness is considered as part of activity 11.”

The descriptors have been altered as well, they now read;

A. Can stand and then move more than 200 metres, either aided or unaided. 0ptsB. Can stand and then move more than 50 metres but no more than 200 metres, either aided or unaided. 4ptsC. Can stand and then move unaided more than 20 metres but no more than 50 metres. 8ptsD. Can stand and then move using an aid or appliance more than 20 metres but no more than 50 metres. 10ptsFor example, this would include people who can stand and move more than 20 metres but no further than 50 metres, but need to use an aid or appliance such as a stick or crutch to do so. [Not including wheelchairs]E. Can stand and then move more than 1 metre but no more than 20 metres, either aided or unaided. 12ptsF. Cannot, either aided or unaided, i. stand; or ii. move more than 1 metre. 12pts

This is a slight improvement, in that we now know that wheelchair users who need a chair to mobilise 20m or more are protected. Still, it’s far less than ideal. It would be far better if the distance was raised from 20m to 50m.

There has been a huge tide of negative news around the PIP changes recently, which whilst fully deserved, is also very upsetting when it’s all you hear & read day in and day out. I think we should take what positives we can from this. That’s not to say that we shouldn’t keep campaigning to get the changes made that we want to see, but that we should all take a few seconds to pat ourselves on the back before plugging onwards. These changes would not have been made without the tireless campaigning and awareness raising work hundreds of disabled people across the country.

If you want to keep fighting these changes you can have a look at the We Are Spartacus campaign group website for ideas and to keep up-to-date with developments.

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There are some worrying things in there – like reliability not applying if a descriptor is about being 'unable' to do something – but none of the the descriptors use the word 'unable'.

There's also a bit that seems, reading between the lines, to be telling HCPs to ignore stuff from GPs (when weighing evidence, consider whether the person providing that evidence is being objective or being the claimant's advocate, basically).

Oh, and the assessor can use their discretion, and if the claimant has a companion with them and they consider the companion to be obstructive to the assessment, they can remove the companion. Not sure if that's true for the WCA.

You are right there, I worry about the language empowering assessors to deviate from guidelines on the basis of a persons behaviour during a extremely stressful, out of the ordinary, interview. One can only imagine that a lot of “suspicions” that HCP's may have that cause them to deviate from the guidelines will be mired in personal prejudices (of the institutional variety & a desire to meet 'targets').

I do worry about the last point you made too. I can see that it is sometimes useful for friends and family not to be around when discussing sensitive issues and I know that sometimes they can be obstructive (not letting people speak etc…). I do worry though that it could be used an an excuse to remove advocates & helpful friends and family who challenge the HCP's for whatever reason.

Also the guidance that moving 20m repeatedly is the level of mobility needed to maintain independence at home – clearly, this is there to say that, if people don't use a chair at home and are relatively independent at home, they can't get a 12 point descriptor on Activity 12.